OMC Patient Observations Survey

2. Please rate the cleanliness and professional appearance of the waiting area.
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This is a required question

3. Please rate the reception you received.
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This is a required question

5. You felt like:
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This is a required question

6. Staff greeted you with a smile and addressed you by name
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This is a required question

7. Knowledge and efficiency in assisting you
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This is a required question

8. Overall courtesy and helpfulness
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This is a required question

9. Experience with the physician’ s exam
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This is a required question

10. What do you expect in a physician?
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This is a required question

11. Did you receive instructions for follow up care that were clear and concise?
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This is a required question

12. If you were referred to a specialist, was that scheduled within:
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This is a required question

If more than 5 days, how long?

This is a required question

13. Was your visit to OMC due to an injury or a scheduled employment exam?
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This is a required question

14. Did you wait to be called beyond your scheduled appointment time?
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This is a required question

Month/Year when the employee visited OMC
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This is a required question

Thank you for assisting us in evaluating our services.
If you would like to speak with us, please provide your name, phone number and best time to call below.
Additional comments/suggestions may be recorded in this area.

This is a required question

THIS IS A CUSTOMER SURVEY DESIGNED TO HELP US TO BETTER SERVE YOU IN THE FUTURE. IF YOU WISH TO SUBMIT A QUESTIONS OR COMPLAINTS, PLEASE CONTACT US DIRECTLY AT OUR WEBSITE @ www.occumedonline.com